APPLICATION FOR CASE REFERRAL 227 LAND USE LITIGATION DOCKET JD-CV-129 Rev. 4-18 COURT USE ONLY LANDUSE *LANDUSE*STATE OF CONNECTICUT SUPERIOR COURT CIVIL DIVISION www.jud.ct.gov Instructions 1. Counsel and self-represented parties seeking to have a case referred to the Land Use Litigation Docket at Hartford must supply all of the information requested below. Without complete and accurate information, this case may not be transferred. 2. Information that does not fit on this form should be attached on a separate sheet, numbered to correspond to the questions on the form. 3. File with the Clerk in the judicial district in which the case is pending. 4. For all parties required to e-file, this Application for Case Referral must be e-filed and the filer must select 223Land Use Litigation Application" when naming the form in e-filing.Note Any objection to the transfer of this case to the Land Use Litigation Docket must be filed within 15 calendar days after the filing of this application. In all cases that require e-filing, the filer must select "Objection to Transfer to Land Use Litigation Docket" when naming the objection in e-filing. File the objection with the Clerk in the judicial district in which the case is pending. ADA NOTICE The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA. Case name (Plaintiff v. Defendant) Docket number Return date Type of land use matter Affordable Housing Appeals Environmental Enforcement Planning/Zoning Inland/Wetlands Miscellaneous Land Use Litigation1. Status of litigation:a. Administrative appeal: Briefs filed: Yes No Record filed: Yes Nob. Miscellaneous land use litigation/environmental enforcement: Pleadings: Open Closed Discovery complete: Yes Noc. Trial date assigned: Yes NoIf yes, when is the trial? Estimated length of trial: 2. Reasons why this case should be referred to the Land Use Litigation Docket:3. List any related cases:4. Do the parties or attorneys consent to the transfer to the Land Use Litigation Docket? Yes No Do not knowCertificationI certify that a copy of this document was or will immediately be mailed or delivered electronically or non-electronically on (date) to all attorneys and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented parties of record who received or will immediately be receiving electronic delivery. Name and address of each party and attorney that copy was or will be mailed or delivered to**If necessary, attach additional sheet or sheets with name and address which the copy was or will be mailed or delivered to. Signed (Signature of filer) u Print or type name of person signing Date signed Mailing address (Number, street, town, state and zip code) Telephone number American LegalNet, Inc. www.FormsWorkFlow.com